Hello,
Thanks for your query at doctorspring.com. I can understand your concern.
Your central sharp chest pain doesnt seem to be anginal in origin. Also your CT angio report is not suggestive of significant coronary artery disease.
Please answer the following questions to help me assess your condition better.
About your dizziness. Does it always occur when you have this chest pain?
Does it occur with this thumping sensation in your chest?
Does your thumping sensation occur with your chest pain?Have you noticed your heart rate or pulse rate during these episodes?
Do objects spin before your eyes? or your head spins? or are there blackout sensations?
What does waking with passing out sensation mean?
Have you got an ECG done? Please get an ECG done preferably when you have an episode. Holter and 2d echo would be the next logical investigation.
Please get back with the info, also please feel free to discuss follow-up questions.
Thank you. Regards.
Patient replied :
Hello Dr
My dizziness is not directly associated with chest pain, in fact they seem separate.
Thumping sensation has been there for a few months with no pain. Pain is recent (2 weeks).
My resting heart rate is about 70-80bpm, which seems a little high.
The dizziness is not spinning but more of a mild blackout sensation (never fully blacked out)...
I have had three episodes where while asleep I have suddenly woken up with the blackout sensation, heart rate quite high and heart thumping! I know this sounds strange (as I'm already asleep). It lasted about 10 mins each time and I was able to get back to sleep.
Yes I was on the ECG for for 24hrs in hospital, with no alerts or problems.
I'm not sure if it was Holter and/or 2d echo?
I am back at work now (desk job) and the pain has subsided a lot, but the mild blackout dizziness still comes and goes throughout the day, even when just sitting typing like at the moment.
I have a discharge summary I can upload if that would help?
Thank you for your time.
Mark
Well, one thing we can be reasonable sure is that the dizziness is not related to a heart problem. The chest pain is not typical of a cardiac problem, the ECG monitoring was normal and all other tests do not show any major problem. Moreover the chest pain and dizziness symptoms do not appear to directly relate. A heart rate less than 80 is perfectly normal. So from cardiology point of view things seems to be fine.
The dizziness or rather blackouts has some features of a mild panic attack. Please note, I am not saying this is panic attack. Since you have been medically evaluated in a thorough manner, you can just observe or rather watch and wait.
In case if the symptoms persist or worsens you may need further investigations like 2D echo and Halter (these are some investigations for your heart). But I do not think you will need this. Meanwhile I recommend you to avoid any personal or work related stress. Stay in company with friends and family. Stay physically active. (mild to moderate aerobic exercise for 30 minutes per day)
Hope this helps
Thank you.